Why is Thailand One of the Most Popular Medical Destinations in the World? The only country in Southeast Asia never to have been colonized, Thailand is a self-confident, outward-looking, internationally focused country and has always been an attractive destination to foreigners. But there are many more reasons for its allure.By Dr.Moreton
Many companies and international agencies choose Bangkok for their Asian headquarters. Its climate and positive attitude toward foreigners has also made it a popular destination for retirees, whether as permanent or occasional residents. The country has responded by providing medical care for these visitors. BNH Hospital (previously known as Bank Nursing Home) was established in 1898 as the first hospital to offer care to foreign residents. Other hospitals followed and now the country has a series of international hospitals dedicated to providing high-caliber medical care to Thais, expatriate resident, tourists and patients coming to Thailand specifically for medical care.
Thailand has succeeded in creating an admirable healthcare system by combining its own inherent sense of warmth and hospitality with a well-educated medical technology. For ever a century, Thai doctors have been training in the west, then returning home to introduce and integrate their new skills into the Thai system.
For the “Thai people, there is a system of universal healthcare throughout the country. In each district, health centers staffed by nurses dispense primary care at very little cost to their patients. A system of community hospitals provides primary and some secondary care throughout the country. Each province has provincial hospitals providing secondary and some tertiary care.
Young doctors as part of their national obligation are required to spend two to three years providing care in these hospitals. Medications, with some limitations, are also provided without cost. In the major cities, government hospitals provide primary, secondary and tertiary care to local patients and those referred to them.
Like health services throughout the world there are budgetary and other problems, but Thailand delivers a standard of care that is superior to any of its neighbors.
Private insurance is available and companies with more than five employees are required to offer health insurance as a benefit, enabling this sector to access private hospitals. The public and private systems exist together in a cooperative manner, sharing programs and expertise, senior doctors customarily working in both the public and private systems. The Health Ministry audits the work of the hospitals and is meticulous in its licensing and inspection procedures.
For many years, visitors to Thailand came to realize that excellent medical care was available at affordable prices and took advantage of the facilities; from this base the medical tourism sector has evolved and grown.
Independent private hospitals with no direct government funding are now present in all the major cities and in the areas of the country where there is a high concentration of foreigner, and several Thai hospitals have received accreditation from Joint Commission International and other authorities.
Bangkok Dusit Medical Services is the largest hospital group in Thailand and the second biggest in Asia. There are 18 hospitals in the group the flagship being the 600-bed Bangkok Hospital Medical Center in Bangkok. Sixty percent of its patients are Thai nationals and the other forty percent are from other countries. This second group can be categorized into visitors, both tourists and business people, expatriates resident in Thailand or neighboring countries, and medical tourists who come to Bangkok specifically for medical care.
Their motivations for coming to Thailand vary from country to country and patient to patient. For some, the treatment may not be available or available only after a long wait or at a prohibitive cost. The factors that are important in their choice are the physical attractiveness of Thailand as a destination and the well-deserved reputation of the Thai healthcare community for professionalism, courtesy and kindness. The high quality of the care is undoubtedly the most important factor and Thailand has established a reputation for excellence. Some of the hospitals have areas of special expertise: BNH, for example, has a well-deserved reputation in the area of spinal surgery and Bangkok Hospital has an international reputation for its cardiac, neurological and cancer centers.
Communication is an important factor. In recent years an increasing number of Thai doctors have received training abroad. particularly in the UK and US, and many hold American Board or Royal College certification. The English-speaking skills of the doctors are excellent and interpreters are available to assist in 29 other languages, Dr Somarch Wonghomthong, the director of Bangkok International Hospital says that “we understand that respecting people’s traditions, tastes and faith, enabling them to communicate in their own language and enjoy their own food, has a positive effect on medical outcomes.”
The hospitals understand that patients coming from other countries may be apprehensive about coming to Thailand for care. The hospitals are well placed and easily accessed from the areas where foreigners live or stay. They also have elaborate concierge services, meeting patients at the airport and bringing them either to hotels or to the hospital. Immigration and other formalities are taken care of in order to make the patient’s arrival quite seamless. Arrangements have been made with local hotels for accommodation of outpatients or families and serviced apartments are available on-site for this purpose. The concierge departments can help patients and families with visa problems should they overstay, and rebook airline tickets when necessary.
Patients are routinely referred into the tertiary care units in Bangkok from all over Thailand and neighboring countries; Bangkok Hospital has a dedicated Eurami-certified medical evacuation team and is able to send either an ambulance or fixed-wing or helicopter and bring patients in from all over Thailand, Laos, Cambodia and Vietnam. In-flight assessment and treatment can be given by the trained medical flight crew while being transported to the hospital. The larger hospitals even have aviation medicine departments that can facilitate these transfers and also arrange repatriation, accompanied by doctors and nurses if necessary.
Bangkok Hospital has a referral center and receives many hundreds of enquiries by email and telephone from throughout the world. A telephone hotline with English-speaking agents is available twenty-four hours a day. Patients may also ‘walk-in’ either to emergency rooms or request an appointment at a primary care or specialty clinic.
Cost is an important factor in deciding where to seek medical care, and the hospitals in Thailand are able to offer care at a lower cost than are hospitals in other countries. Low cost, however, has never been the main focus; quality of care is always the first consideration.
Dr Moreton graduated from the University of Liverpool Medical School and trained as an Obstetrician and Gynaecologist in Montreal. After practicing in the US and Canada for many years he went to China, where he established the first western-style maternity units in Beijing and Shanghai. He is now the International Medical Coordinator at Bangkok Hospital Medical Center. A prolific writer, Dr Moreton contributes a monthly column to the Bangkok Hospital eNews. He can be reached at Mmoreton@bgh.co.th.